I met with Dr. Jerry Pluss, D.O., with East Denver Pulmonary, for my pulmonary evaluation on Friday 7/27. I was very impressed with Dr. Pluss -- he spent a full hour with me, asking questions and conducting an exam. He is quite personable and chatted with me, which I liked. We spent a lot of time discussing the sleep apnea and he agreed he would monitory the apnea -- he said that many times people will get a sleep study done, and maybe even get a CPAP machine for home, but then receive no follow-up care or monitoring of the apnea. Dr. Pluss will do the referrals necessary to get me the home CPAP equipment and will monitor my progress every 4-6 weeks. It was . . . amazing . . . that a doctor spent so much time with me. Doctors rarely spend time with their patients -- I'm sure I'm not the only person who has been told that if I have any issues to talk about with my PCP, other than the symptom or condition that prompted my appointment, I would have to schedule a separate appointment with my doctor, as the doctor only has 15 minutes alloted for the appointment.

Dr. Pluss reviewed all my records from my previous testing in 2004 (I had attempted to get gastric bypass in 2004 through Aetna -- no dice) and noted that my pulmonary functions were excellent at that time, and that my echocardiogram had also been complete normal. I had to have an echocardiogram in 2004 because I had taken Phen-Phen in the early 90s, for about a week. No damage done, thank God.

Some of you know that I went through the pre-op procedures for WLS in 2004. Here is what happened on June 23, 2004, during my pulmonary functioning test which required an arterial blood/gas draw (reposted from my other LJ):

Today I had a full pulmonary evaluation -- breathing tests -- for a reason I shall not bore you all with; however, I ended up utterly physically traumatized!!! Okay, I have no problem getting my blood drawn. None at all. Part of the pulmonary function test included an *arterial* blood-gas draw, though, which is different than drawing blood from a regular vein. The respiratory specialist was very kind, and spent about five minutes explaining the differences between the two types of blood draws, and made sure to tell me that if anything hurt -- above and beyond the normal, minor discomfort associated with getting a needle stick -- to tell him, etc. So he sticks the needle into my wrist, just at the area of the pulsepoint, and it's going okay, except the artery is rolling under the tip of the needle (i.e. he couldn't get the needle *into* the artery; it was slipping aside as the needle was trying to breach the artery wall). All of a I sudden I was in the most excruciating pain I have felt since CHILDBIRTH!!! It was seriously akin to certain parts of childbirth -- like being at the heighth of a contraction, for those in the know. My GOD, I couldn't help myself, and I burst into tears and could not stop bawling. The respiratory guy was really nice and calm, and immediately took the needle out, etc.

Apparently my artery spasmed, which is, I now know, very painful. I guess arterial structure is different than that of veins, and they are more rich with nerves; because the blood-gas was for pulmonary reasons, the sample HAD to come from an artery. So the guy moves up to my mid-forearm and collects a perfect sample on his second try -- no pain, no problem. But I am seriously traumatized. Like . . . really traumatized. I was shaky all day afterward, and the pain is still there residually. And I cannot imagine under any circumstances allowing anyone to do an arterial blood draw on me again when I am unsedated.

I could never withstand torture. I'm still very much with the Whoa.

For what it's worth, it took about 18 months for the residual numbness and shooting pains to completely resolve. I asked Dr. Snyder, my surgeon, if I could be excused from another arterial blood gas draw -- the trauma of this , and thinking I would have to undergo this again -- caused me to put off seeking WLS for quite a long time. Long story short, I don't have to have it drawn again. Dr. Snyder said I wouldn't have to and Dr. Pluss agreed, noting that my blood/gas from 2004 was perfectly normal. I can't tell y'all how relieved I am.

The reason pulmonary functioning tests are done for weight loss surgery candidates is that one of the leading causes of post-operative death is pulmonary embolism. Certain factors increase one's risk for pulmonary embolism, of course, but I have the risk factor of aura/paralytic migraines that are hormonally induced, which can be a pre-cursor to stroke. Therefore, I have never been able to take any kind of hormonal birth control, such as the pill, the shots, the thingees under the skin, etc. I've only had about ten migraines in my life where I lost the feeling in one side of my body, but it was scary and I have to be careful.

I also went for a pre-op lung function test that Dr. Pluss ordered for Dr. Synder for the same reasons as you (WLS). I also had the arterial blood gas draw. My experience was nothing like yours but it indeed hurt very much. This was the first time I had ever had this procedure performed. I have had asthma for 15 years and no one had ordered this test, not even National Jewish. I am now on oxygen due to this test and may lose my job because of it. I had thought that my breathing problems were from my asthma and sinus drainage so I just used my inhaler according to what I had done in the past and suffered as it was not helping me. No one picked up on the fact that I was not having asthma like conditions (very hard to breath/wheezing v/s the feeling of not enough air and no wheezing). I am lucky Dr. Pluss ordered this test. He spent a long time with me, asking many questions and conducting an exam at the same time. He was very kind and caring. One week after meeting with Dr. Pluss, a gentleman came to my door with my oxygen and set me up. After he left I felt sadness at what was happening to me. I just could not believe this was to be true. I was stunned and cried for hours. I really felt alone and still do as it has only been 4 days now sense the delivery of my machine. I had no idea I was in this condition. I used the oxygen for two hours on a Saturday. The next morning I had a terriable headache, nausea, was confused and ready to pass out. I have no idea why. On Sunday afternoon I used the oxygen again as I cleaned house, (my oxygen drops from 97 to 67 with activity) and again on Monday morning I had all the same problems but worse. I missed work that day. I am thinking that this may be related to the oxygen. I am not sure. I wonder if this has happened to anyone else. To make a long story short I am glad I received the blood test yet not happy on the results. I also have Dr. Synder for my doctor and for the same reasons as you (WLS) and I also was denied by my insurance company (Pacificare). This is starting to be the trend with the insurance company's now as so many people are getting WLS due to the goodness it is doing with their health.